Provider Demographics
NPI:1376697029
Name:TOMANELLI, DOUGLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:TOMANELLI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4513 HIXSON PIKE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5039
Mailing Address - Country:US
Mailing Address - Phone:423-877-1558
Mailing Address - Fax:423-877-1543
Practice Address - Street 1:4513 HIXSON PIKE
Practice Address - Street 2:SUITE 104
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-5039
Practice Address - Country:US
Practice Address - Phone:423-877-1558
Practice Address - Fax:423-877-1543
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation